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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Plasmodium falciparum population dynamics during the early phase of anti-malarial drug treatment in Tanzanian children with acute uncomplicated malaria
Malaria Journal, Volume 10, Article 380, Year 2011
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Description
Background: This study aimed to explore Plasmodium falciparum population dynamics during the early phase of anti-malarial drug treatment with artemisinin-based combination therapy in children with clinical malaria in a high transmission area in Africa. Methods. A total of 50 children aged 1-10 years with acute uncomplicated P. falciparum malaria in Bagamoyo District, Tanzania, were enrolled. Participants were hospitalized and received supervised standard treatment with artemether-lumefantrine according to body weight in six doses over 3 days. Blood samples were collected 11 times, i.e. at time of diagnosis (-2 h) and 0, 2, 4, 8, 16, 24, 36, 48, 60 and 72 h after initiation of treatment. Parasite population dynamics were assessed using nested polymerase chain reaction (PCR)-genotyping of merozoite surface protein (msp) 1 and 2. Results: PCR-analyses from nine sequential blood samples collected after initiation of treatment identified 20 and 21 additional genotypes in 15/50 (30%) and 14/50 (28%) children with msp1 and msp2, respectively, non-detectable in the pre-treatment samples (-2 and 0 h combined). Some 15/20 (75%) and 14/21 (67%) of these genotypes were identified within 24 h, whereas 17/20 (85%) and 19/21 (90%) within 48 h for msp1 and msp2, respectively. The genotype profile was diverse, and varied considerably over time both within and between patients, molecular markers and their respective families. Conclusion: PCR analyses from multiple blood samples collected during the early treatment phase revealed a complex picture of parasite sub-populations. This underlines the importance of interpreting PCR-outcomes with caution and suggests that the present use of PCR-adjustment from paired blood samples in anti-malarial drug trials may overestimate assessment of drug efficacy in high transmission areas in Africa. The study is registered at with identifier NCT00336375. © 2011 Carlsson et al; licensee BioMed Central Ltd.
Authors & Co-Authors
Carlsson, Anja M.
Sweden, Stockholm
Karolinska Universitetssjukhuset
Ngasala, Billy E.
Sweden, Stockholm
Karolinska Universitetssjukhuset
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Dahlström, Sabina
Sweden, Stockholm
Karolinska Universitetssjukhuset
Membi, Christopher D.
Tanzania, Ifakara
Ifakara Health Institute
Veiga, Maria Isabel
Sweden, Stockholm
Karolinska Universitetssjukhuset
Portugal, Faro
Universidade do Algarve
Rombo, Lars
Sweden, Stockholm
Karolinska Universitetssjukhuset
Sweden, Eskilstuna
Sörmland County Council
Abdulla, Salim Mohammed K.
Tanzania, Ifakara
Ifakara Health Institute
Premji, Zulfiqarali G.
Tanzania, Dar es Salaam
Muhimbili University of Health and Allied Sciences
Gil, Jose Pedro
Sweden, Stockholm
Karolinska Universitetssjukhuset
Portugal, Faro
Universidade do Algarve
United States, Binghamton
Binghamton University State University of new York
Sweden, Stockholm
Karolinska Institutet
Bjǒrkman, Anders B.
Sweden, Stockholm
Karolinska Universitetssjukhuset
Mårtensson, Andreas A.
Sweden, Stockholm
Karolinska Universitetssjukhuset
Sweden, Stockholm
Karolinska Institutet
Sweden, Katrineholm
Kullbergska Hospital
Statistics
Citations: 31
Authors: 11
Affiliations: 8
Identifiers
Doi:
10.1186/1475-2875-10-380
e-ISSN:
14752875
Research Areas
Genetics And Genomics
Infectious Diseases
Maternal And Child Health
Study Design
Cross Sectional Study
Study Locations
Tanzania